JP2002523137A - Bifurcated catheter assembly - Google Patents

Abstract

There is described a bifurcated catheter assembly provided for treating bifurcated vessels. The bifurcated catheter assembly comprises an elongate main catheter shaft having a stiffer proximal portion, a more flexible distal portion, and a pair of branch catheters attached to the distal portion. An expandable member is located on each of the branch catheters. The balloons are held together to provide a low profile as the device is advanced over the tracking guide wire. Upon reaching the bifurcated vessel, the balloons separated and are advanced over separate guide wires into separate branches of the bifurcated vessel. The bifurcated catheter assembly can be used to dilate a stenosis or deliver and implant a Y-shaped stent in the bifurcation.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

TECHNICAL FIELD OF THE INVENTION

The present invention relates generally to balloon catheters used in the treatment of vascular diseases. More particularly, the present invention relates to a bifurcated catheter assembly where two parallel dilatation balloons are provided at the tip of a single catheter shaft. Bifurcated catheter assemblies provide an improved means for treating arterial bifurcations.

[0002]

[Prior art]

In a medical procedure known as percutaneous transluminal vasodilation (PTCA), coronary arteries that become stenotic or restricted by the accumulation of plaque along the arterial wall (
Or other blood vessels) are treated using a balloon catheter. In PTCA surgery,
A balloon catheter is inserted percutaneously and advanced through the lumen of the coronary artery to the stenosis. The balloon is then inflated and the lumen of the artery is dilated by pressing the plaque against the artery wall to ensure proper blood flow.

After performing a PTCA procedure, a stent, which is well known in the art, is expanded at the treatment area to prevent restenosis and maintain an unobstructed passage for blood flow. The stent is then inflated and implanted in the blood vessel by temporarily inflating the balloon. The balloon catheter assembly is then removed from the lumen leaving the implanted stent in the vessel to deflate the balloon, support the vessel wall, and prevent restenosis.

[0004] While many arteries with disease states can be adequately treated in this manner using conventional balloon catheters and stents, arteries with bifurcation disease are difficult to treat with currently available devices. . For example, if one of the bifurcation vascular passages is treated using a conventional balloon catheter during PTCA, the pressure due to the inflation of the balloon in the treated passage restricts blood flow to the untreated passage. There is. This is by pushing the bifurcation over the entrance to the untreated vessel. In addition, the pressure of the balloon in the treated passage may cause the plaque to move from the treated passage to the untreated passage. As a sufficient amount of plaque moves into the untreated passage, the entrance to the untreated passage becomes blocked, making it difficult to insert guidewires and catheters to perform PTCA on untreated vessels. Or become impossible.

[0005] Furthermore, deploying a stent at a bifurcation is very difficult because the stent must be covered over the diseased area of the bifurcation, and the stent itself must not impede blood flow. It is. Conventional stents are designed to repair an area of the blood vessel that is remote from the bifurcation, which typically terminates at a right angle to its longitudinal axis, thus resulting in a vascular bifurcation. Use of a conventional stent in the area of the obstruction may occlude blood flow in the side branch (commonly referred to as "jailing" of the side branch) or may require a branch It cannot be repaired to the fullest extent. To be effective, the stent must cover the entire perimeter of the portal and must extend into and beyond the diseased area. If the stent is not covered all the way around the entrance to the diseased part, the stent cannot completely repair the bifurcated blood vessel.

[0006] To overcome the problems and limitations associated with using conventional stents, Y-shaped stents for bifurcation treatment have been proposed. Such a stent has the advantage of completely repairing the blood vessel at the bifurcation without interrupting blood flow elsewhere in the bifurcation. Further, such a stent has access to all parts of the branch vessel that need to be treated. With disease at the beginning of the horned aortic ostium, such stents have the advantage of completely repairing the vascular apex without protruding into the mouth or performing complex, repeated access. . Although the proposed Y-shaped stent provides an improved device for repairing bifurcations, insertion and deployment of such stents is not easily accomplished with conventional balloon catheters.

[0007] Because conventional balloon catheters are not suitable for treating arterial bifurcations, many physicians currently insert two separate balloon catheters into a guide catheter and move each balloon over a separate guidewire. "Kissing balloon (kissi)
ng ballon "technology. After advancing the guide catheter to a point just before the bifurcation, the two guide wires are advanced from the distal end of the guide catheter into separate vascular passages. The two balloon catheters are then moved along the guidewire into their respective passages. The balloons are inflated simultaneously using separate inflation media or using a manifold to split flow from a single source of media. By using two catheters for PTCA or stent expansion, both vessel passages can be treated simultaneously at the bifurcation.

[0008] Although effective overall, there are significant drawbacks to using two single balloon catheters to treat arterial bifurcations. For example, the emergence of two similar catheters from the proximal end of the guide catheter makes it difficult for a physician to manage both devices without causing confusion as to which catheter controls which balloon. In addition, the presence of two balloon catheters within one guide catheter increases the profile of the device, which allows the radiopacity to be injected into a blood vessel so that the physician can see the bifurcation. The amount of dye is limited.

[0009] Efforts have been made to develop balloon catheters specifically designed for the treatment of arterial bifurcations. With these efforts, a Y-shaped balloon placed at the tip of the catheter has been proposed. The balloon is inflated at the bifurcation to treat both passages simultaneously. Although a Y-shaped balloon provides an improvement over using two separate balloon catheters, the proposed device is impractical. This is because it is difficult to manufacture a Y-shaped balloon, attach it to the catheter shaft, and properly position it at the vessel bifurcation. This type of device is
It is described in International Patent Application No. WO 97/16217 entitled "Aortic Bifurcation Angioplasty Device" filed on October 30, 1995.

[0010]

[Problems to be solved by the invention]

Thus, there is a need for an improved balloon catheter that can be used for effective treatment of arterial bifurcations for both delivery and deployment of PTCA and stents. Moreover, such balloon catheters are desirably easy to use, inexpensive to manufacture, and can be made from materials common in today's industry. The present invention seeks to meet this need.

[0011]

[Means for Solving the Problems]

The present invention provides a bifurcated catheter assembly that can be used to simultaneously dilate both stenoses of both the main vessel and the side branch vessels of the bifurcation, and furthermore makes the delivery and deployment of the Y-shaped stent quick and easy. To provide a means for doing so. The present invention includes a single catheter shaft with two individual parallel balloons at the tip.
The parallel balloons travel along separate guidewires at the bifurcation and into separate vascular passageways and are inflated simultaneously by inflation media from a common source. Although the invention is designed primarily for use in the coronary arteries, it can also be used to treat other blood vessels such as the renal, abdominal aorta, femoral, and carotid arteries.

The bifurcated catheter assembly of the present invention includes a catheter body having three lumens at the distal end. The first lumen is an inflation lumen for a pressurized inflation medium used to inflate and deflate the balloon. The second lumen is a guidewire lumen containing a tracking guidewire, and the third lumen is also a guidewire lumen containing an integral guidewire.

Two parallel catheter branches are connected to the distal end of the catheter body. Each of the parallel catheter branches has two lumens. One lumen is an inflation lumen that communicates with the inflation lumen of the catheter body, and the other lumen is a guidewire lumen that communicates with one of the guidewire lumens of the catheter body. An inflatable member such as a balloon is disposed around each catheter branch. These balloons are in communication with the inflation lumen of each catheter branch. An inflation notch on the side of each catheter branch allows pressurized inflation media to enter and exit the balloon. The guidewire lumen of each catheter branch extends all the way to the distal end so that the guidewire can be advanced distally from each branch.

A tracking guidewire is advanced through the main vessel and the guidewire is advanced through the entrance at the bifurcation and into the side branch vessel. With one guidewire advanced into each passage of the bifurcation, the first balloon moves into the main vessel passage according to the tracking guidewire, and the second balloon moves into the side branch vessel passage according to the integrated guidewire. The bifurcated catheter assembly is advanced to move to.

The bifurcated catheter assembly can be used at the arterial bifurcation to both deliver and implant PTCA and stents. Other features and advantages of the present invention will become apparent from the following detailed description, taken in conjunction with the accompanying drawings, illustrating by way of example the features of the invention.

[0016]

BEST MODE FOR CARRYING OUT THE INVENTION

The present invention includes assemblies and methods for treating coronary arteries, veins, arteries, and bifurcations of other blood vessels in the body. As shown in FIG. 1, the artery bifurcation is
A location in the body's vascular system that divides into two vascular passages. FIG. 1 shows how plaque deposits on the walls of arteries, causing a stenosis known as stenosis. Stenosis can be dilated by pressing a plaque against the vessel wall using a balloon catheter in a procedure known as PTCA. After performing PTCA, the stent is deployed intravascularly to reduce the likelihood of recurrence of stenosis.

Conventional techniques for treating arterial bifurcations have proven unsatisfactory. For example, FIGS. 2, 3, and 4 show conventional techniques for treating an arterial bifurcation. These techniques use a single balloon, two single balloons, and a Y-shaped balloon. Referring to FIG. 2, a single balloon catheter is inserted into one of the branches and inflated to dilate the stenosis. The use of a single balloon catheter to treat an arterial bifurcation requires that each vessel passage in the bifurcation be individually dilated. When using this method, the dilation of the treated passage may push the walls of the untreated passage to block blood flow to the untreated branch, or move the plaque from the treated passage to the untreated passage. I will. Thus, this technique is inadequate and often has undesirable consequences that are harmful to the patient.

[0018] Many physicians have attempted to treat the bifurcation by using a "kissing balloon" technique. Referring to FIG. 3, this prior art device and method uses two separate balloon catheters, both of which are inserted into a guide catheter and moved according to separate guidewires. At the bifurcation, a balloon is advanced into each of the vascular passageways, one at a time, to inflate these balloons simultaneously to dilate the stenosis, or to dilate the vessel before delivering two separate stents to the bifurcation. To expand. However, in practice, the use of two separate single balloon catheters is cumbersome and it is difficult for a physician to manage both devices. Further, the presence of the two catheter shafts within the guide catheter limits the contrast or flow of the control discriminating agent through the guide catheter, which makes it difficult for the physician to see the area to be treated.

As shown in FIG. 4, another prior art device includes a single catheter with a Y-shaped balloon at the tip. This device has been proposed as an improved means for treating arterial bifurcations. The prior art discloses advancing a Y-shaped balloon through the lumen of a blood vessel and inflating it at a bifurcation to expand both passages simultaneously or implant a Y-shaped stent. Although the Y-shaped balloon offers improvements over kissing balloon technology, the utility of the proposed Y-shaped balloon is questionable. This is because it is difficult to manufacture, has problems associated with positioning and deploying (eg, wire wrapping) at the bifurcation, and is generally bulky.

The prior art arterial bifurcation treatment methods shown in FIGS. 2, 3 and 4 have various disadvantages, which are overcome by the present invention.

Referring to FIGS. 5-10 and 12, the bifurcated catheter assembly of the present invention provides two separate balloons in parallel. These balloons can be advanced into separate passages in the arterial bifurcation and simultaneously inflated to expand the stenosis or deploy the stent. Bifurcated catheter assembly 10
Generally includes a catheter body 11 having a proximal portion 12 through which a first inflation lumen 14 and a first guidewire lumen 16 pass. The proximal portion of the catheter body is preferably a stainless steel tube surrounded by a polymer jacket (not shown). The polymer jacket can be formed of various materials that enhance lubricity, including polyethylene, nylon, polyethyl ether ketone, and copolyester-elastomer. An inflation hub 21 is located at the proximal end of the proximal portion of the catheter body for mounting the inflation device.

In a preferred embodiment, the bifurcated catheter assembly is a quick-change assembly known in the art. Referring to FIGS. 5 and 6, the first guidewire lumen 16 includes a first outlet port 18 provided at the proximal end of the catheter assembly 10. An integral guidewire 15 extends from outside the first exit port 18 into the first guidewire lumen 16 and through the lumen. As shown in FIG. 7, the second guidewire lumen 17 is of a quick-change type and is formed to slidably receive a tracking guidewire 19. The second guidewire lumen 17 exits the catheter body 11 at the second exit port 20.

Optionally, a slit 13 may be provided in the catheter body 11 between the guidewire outlet port 20 and a position immediately proximal of the balloon 42. Thereby, the catheter body can be "peeled off" from the tracking guide wire 19,
This makes replacement of the catheter more convenient.

The proximal portion 12 of the catheter body 11 is connected to the distal portion 22 of the catheter body 11. The distal portion 22 of the catheter body 11 is preferably formed from a polymeric material to increase flexibility at the distal portion of the catheter. The distal end portion 22 of the catheter body 11 includes a first inflation lumen 14 for carrying an inflation medium.
, A first guidewire lumen 16 containing an integral guidewire 15, and a second guidewire lumen 17 containing a tracking guidewire 19. By the connecting portion 30 between the proximal portion 12 and the distal portion 22 of the catheter body 11,
The expansion medium can flow continuously between the proximal end and the distal end without leakage.

FIG. 8 shows a cross section of the catheter branch 32. The catheter branch 34 has a similar cross-sectional configuration.

The distal end portion 22 of the catheter body 11 is connected to first and second parallel catheter branches 32 and 34, respectively. A connection 36 between the catheter body and each of the parallel catheter branches allows inflation media to be transferred from the first inflation lumen of the distal shaft to the second and third inflation lumens 37, 38 of each of the catheter branches. Up to continuous flow. The parallel catheter branches 32,34 respectively have second and third inflation lumens 37,38 for communicating the inflation medium, and first and second for passing the integral guidewire 15 and tracking guidewire 19, respectively. Second guidewire lumen 16
, 17 are included. The first and second catheter branches have distal tips 46, 48, respectively, through which the guidewire exits the guidewire lumen. The tracking guidewire 19 exits the distal tip 46 of the first catheter branch 32. The integral guidewire 15 exits the distal tip 48 of the second catheter branch 34. As shown in FIG. 12, a connecting device 54 in the form of a short tube is attached to the side of the distal end of the second catheter branch portion 34. During advancement of the catheter assembly, the tracking guidewire 19 exits the first catheter branch 32 and the second catheter branch 34.
To hold the two catheter branches together.

Each of the catheter branches 32, 34 is fitted with an inflatable member, preferably in the form of balloons 42, 44. Balloons can be formed from many different materials, including polyethylene, polyolefin copolymers, polyethylene terephthalate, nylon, and Pebax. Inflation hub 21 receives pressurized inflation fluid and supplies inflation fluid to inflation lumens 14, 37, and 38. Each catheter branch includes inflation notches (notches 50 and 52, respectively) that allow the inflation medium to exit the catheter and inflate the inflatable member.

In a preferred embodiment, the overall length of the catheter is between about 135 cm and 150 cm, and the length of the catheter body between the inflation hub 21 and the connection portion 30 is about 125 cm
It is. The proximal portion of the catheter body preferably has a diameter of about 0.75 mm and each of the connection between the proximal and distal portions of the catheter body and the catheter branch parallel to the distal portion of the catheter body. The diameter of the distal end portion of the catheter body between the connecting portion 36 and the connecting portion 36 is about 1.5 mm. The first catheter branch 32 is preferably about 10 cm in length and about 1 mm in diameter, and the second catheter branch 34 is about 12 cm in length and about 1 mm in diameter. Typically, the inflatable member is a balloon, which is preferably about 1.5 mm to about 4.5 mm in diameter when inflated to treat a coronary artery and about 20 mm long. These dimensions will vary widely depending on the particular application and body lumen to be treated.

The assembly of the present invention provides pushability over both guidewires.
) and trackability without deteriorating the trackability. The proximal portion 12 of the main catheter shaft 11 can be formed by necking a jacket material on a stainless steel tube. The jacketed tube is then connected to the distal portion 22 of the main catheter shaft. Mandrels are inserted into guidewire lumens 16 and 17 and the inflation lumen, and these lumens do not collapse when heat is applied during the fusion process to thermally fuse the proximal portion to the distal portion of the main catheter shaft. To do. After cooling the connecting portion 30, the mandrel is removed, leaving a continuous leak-free inflation lumen extending across the catheter assembly shaft.

Each of the parallel catheter branches 32 and 34 is formed as is standard in catheter assembly technology. Balloons 42 and 44 are attached to each branch using known techniques such as heat sealing, adhesives, laser welding, or solvent bonding, or are formed as one piece from the same tubing material as the catheter branch. Is done. The catheter branch is then connected to the distal end of the catheter body using heat to complete the assembly. The method of assembling the catheter can vary according to the materials available and the preferences of the manufacturer.

In use, the tracking guide wire 19 is inserted percutaneously into, for example, the femoral artery, and the tracking guide wire is operated to the bifurcation so that the tip of the tracking guide wire is in the main blood vessel passage on the near side of the bifurcation. The proximal end of the tracking wire 19 is inserted into the short tube of the connecting device 54, and the tracking wire 19 is passed through the tips of both branches. Next, the proximal end of the tracking wire 19 is inserted into the distal tip 46 of the catheter branch 32. This allows the catheter to move smoothly to the target location without interruption. The bifurcated catheter assembly 10 is then advanced over the tracking guidewire until the balloons 42 and 44 are just before the bifurcation in the main vessel passageway. Because the present invention is a rapid exchange catheter, a portion of the tracking guidewire 19 is located outside the catheter, and therefore, has very little frictional resistance during advancement of the assembly. When the balloon is advanced distally over the bifurcation, the tracking guidewire 1 is moved until the distal ends of the tracking guidewire 19 are withdrawn from the coupling device 54 so that the balloons are disengaged from each other.
Pull 9 forward. Next, the tracking wire 19 is advanced again, passes through the tip 46, and enters the main vessel passage. The bifurcated catheter assembly is then withdrawn along the tracking guidewire, thereby placing the balloon short of the bifurcation. With the tracking guidewire in the main vessel passageway, the integral guidewire contained in the second guidewire lumen 17 is advanced from the distal tip of the other catheter branch 34 into the side branch vessel. At this point, one guidewire has emerged from the distal tip of each catheter branch, one at a time, and has entered another passage in the bifurcation. This places the tracking guidewire in the main vessel passage and the integral guidewire in the side branch vessel passage. By advancing the catheter assembly over the guidewire, each balloon is moved along the guidewire into a separate passage in the bifurcation until it is positioned in the stenotic region.

An inflation syringe (or pump) located outside the patient's body is attached to inflation hub 21 and pressurized inflation media is supplied to balloons 42 and 44 through the inflation lumen.
As shown in FIG. 10, with one balloon in each passage, the balloon can be simultaneously inflated during PTCA to dilate the stenosis. Since both passages of the bifurcation are treated at the same time, the passages are not pinched or damaged by PTCA.
In addition, all plaque in the branch is compressed at the same time, and therefore, does not move from one passage to the other. After dilating the stenotic area, the balloons are deflated to their minimum dimensions so that the balloon can be easily withdrawn from the blood vessel.

In the preferred embodiment shown in the accompanying drawings, the device can be removed with the integral wire 15, leaving the tracking wire 19 in the main vessel passage.
This is facilitated by the quick-change configuration of the device in which the tracking wire 19 exits the catheter body 22 and passes through an exit port 20 located approximately 25 cm proximal to the tip of the balloon.

The features with slits mentioned above further facilitate the quick exchange procedure. Optionally, a lumen 16 through which the integral wire 15 passes can be provided in the rapid exchange guidewire exit port of the catheter body. Thus, during catheter exchange, each wire can be maintained in a state of being positioned in each blood vessel. Further, optionally, the lumen 16 may be provided with a slit to further facilitate quick replacement. In this case, a second guidewire exit port is provided on the distal side of the proximal hub.

Another advantage of the present invention is that a Y-shaped stent can be delivered and implanted at the bifurcation, as shown in FIG. In this procedure, bifurcated catheter assembly 10 has a Y-shaped stent 60 attached to a balloon. Balloons 42 and 44 are held together during delivery to provide a low profile that provides space for the injection of radiopaque dye into the bloodstream during the procedure. The tracking guidewire is advanced into the main vessel beyond the bifurcation. The bifurcated catheter assembly is then advanced over the tracking guidewire such that the stent is beyond the bifurcation. The tracking guidewires are then retracted forward, thereby releasing the balloons from each other. Next, with the tracking guide wire left in the main blood vessel, the catheter assembly is pulled to the near side until it comes to the near side of the bifurcation. Next, the integral guide wire is connected to the branch catheter 3.
Outside of 4, advance into the side branch vessels. The catheter assembly is advanced over both guidewires until the balloon and stent are secured to the bifurcation. The balloon is inflated, the stent is inflated and implanted in the bifurcation.

From the above, the bifurcated catheter assembly of the present invention allows both paths of a diseased bifurcation to expand simultaneously during a PTCA procedure, thereby preventing damage to blood vessels and allowing plaque to pass from one path to the other. It will be understood that the transition does not take place. Further, the bifurcated expansion assembly facilitates delivery and deployment of a specially designed Y-shaped stent for use at a bifurcation. The present invention is made of common materials used today in the industry, is simple to use and easy to manufacture.

While particular forms of the invention have been illustrated and described, it will be apparent that various changes can be made without departing from the spirit and scope of the invention.

[Brief description of the drawings]

FIG. 1 is a sectional view of an arterial bifurcation in a disease state.

FIG. 2 is a cross-sectional view of an arterial bifurcation showing a prior art single balloon catheter used to dilate a main vessel.

FIG. 3 illustrates a prior art 2 used to simultaneously dilate both the main vessel and the side branch vessels.
It is sectional drawing of the arterial branch part which shows two balloon catheters.

FIG. 4 is a cross-sectional view of an arterial bifurcation showing a prior art Y-shaped balloon used to dilate both the main vessel and the side branch vessels.

FIG. 5 is a side view of a bifurcated dilatation catheter as an embodiment of the present invention.

6 is an enlarged cross-sectional view of the proximal end portion of the catheter body taken along line 6-6 in FIG. 5;

7 is an enlarged sectional view of the distal end portion of the catheter body taken along line 7-7 in FIG. 5;

8 is an enlarged cross-sectional view of the proximal end portion of one catheter branch taken along line 8-8 in FIG. 5;

9 is an enlarged cross-sectional view of the distal end portion of one of the catheter branches, taken along line 9-9 in FIG. 5;

FIG. 10 is a cross-sectional view of the arterial bifurcation showing both balloons expanded during PTCA.

FIG. 11 is a cross-sectional view of an arterial bifurcation showing a deployed stent of the present invention.

FIG. 12 is a front view of a bifurcated catheter assembly showing the catheter branches connected together.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 10 Bifurcated catheter assembly 11 Catheter main body 12 Base end part 13 Slit 14 First inflation lumen 16 First guidewire lumen 17 Second guidewire lumen 18 First exit port 18 19 Tracking guidewire 20 Second exit port 21 Inflation Hub 22 catheter body 42 balloon

──────────────────────────────────────────────────続 き Continuation of front page (81) Designated country EP (AT, BE, CH, CY, DE, DK, ES, FI, FR, GB, GR, IE, IT, LU, MC, NL, PT, SE ), OA (BF, BJ, CF, CG, CI, CM, GA, GN, GW, ML, MR, NE, SN, TD, TG), AP (GH, GM, KE, LS, MW, SD, SL, SZ, UG, ZW), EA (AM, AZ, BY, KG, KZ, MD, RU, TJ, TM), AE, AL, AM, AT, AU, AZ, BA, BB, BG, BR , BY, CA, CH, CN, CU, CZ, DE, DK, EE, ES, FI, GB, GD, GE, GH, GM, HR, HU, ID, IL, IN, IS , JP, KE, KG, KP, KR, KZ, LC, LK, LR, LS, LT, LU, LV, MD, MG, MK, MN, MW, MX, NO, NZ, PL, PT, RO, RU, SD, SE, SG, SI, SK, SL, TJ, TM, TR, TT, UA, UG, UZ, VN, YU, ZA, ZWF term (reference) 4C167 AA07 AA55 AA56 BB02 BB27 BB39 CC09 DD01 GG06 GG07

Claims (6)

[Claims] 1. A bifurcated catheter assembly for treating a bifurcated blood vessel, wherein the catheter body has a proximal portion and a distal portion, a first inflation lumen, a first guidewire lumen, and a second guidewire lumen. A first catheter branch coupled to the distal end portion of the catheter body, the catheter branch having a second inflation lumen in fluid communication with the first inflation lumen of the catheter body;
A first catheter branch, wherein the first guidewire lumen extends and communicates with the first guidewire lumen in the catheter body; a second catheter connected to the distal end portion of the catheter body. A branch having a third inflation lumen in fluid communication with the first inflation lumen, wherein the second guidewire lumen extends and communicates with the second guidewire lumen of the catheter body. A first inflatable member associated with the first catheter branch and in fluid communication with the second inflation lumen; and a third inflatable member associated with the second catheter branch. A second inflatable member in fluid communication with an inflation lumen, wherein the first and second inflatable members simultaneously inflate the first and second inflatable members to expand a stenosis, Restores patency of lateral branch vessels As
A bifurcated catheter assembly disposed over a respective stenosis in a main vessel and a side branch vessel. 2. The bifurcated catheter assembly according to claim 1, wherein said first and second inflatable members are balloons. 3. The bifurcated catheter assembly of claim 1, wherein said first, second, and third inflation lumens pass pressurized fluid through said first and second inflatable members. 4. The bifurcated catheter assembly according to claim 1, wherein the catheter body has a connector at the distal end of the first catheter branch for connecting to the distal end of the second catheter branch. 5. The bifurcated catheter assembly includes an integrated guidewire slidably received within the first guidewire lumen and a tracking guide slidably received within the second guidewire lumen. The bifurcated catheter assembly according to claim 1, comprising a wire. 6. The bifurcated catheter assembly according to claim 1, wherein the first and second branches are fixedly connected to the catheter body.